Niacinamide lowers cardiovascular disease risk in dermatology patients

Supplementation with niacinamide appears protective against some cardiovascular events, such as myocardial infarction and cardiac arrest, suggests a study.

A team of investigators conducted a retrospective cohort study using the TriNetX platform to examine the relationship between oral niacinamide use and cardiovascular outcomes in patients with multiple nonmelanoma skin cancers (NMSCs).

Patients with two or more NMSCs or bullous pemphigoid who initiated treatment with oral niacinamide (≥500 mg) were matched 1:1 with niacinamide-naïve control participants. Each cohort consisted of 3,231 patients after matching. Various major cardiovascular events were then assessed.

The use of niacinamide resulted in a significant decrease in the risks of ST elevation myocardial infarction (risk ratio [RR], 0.547, 95 percent confidence interval [CI], 0.349‒0.858; p=0.008), peripheral vascular disease (RR, 0.741, 95 percent CI, 0.605‒0.909; p=0.004), and cardiac arrest (RR, 0.500, 95 percent CI, 0.275‒0.909; p=0.020).

Furthermore, these cardiovascular benefits persisted in subgroup analyses by atherosclerotic cardiovascular disease history.

“Niacinamide supplementation is associated with reductions in certain types of cardiovascular events, supporting its use in appropriate patient populations,” the investigators said.

The study was limited by its observation design, preventing causality. The predominantly White population and 3-year timeframe also limited generalizability, according to the investigators.

“Niacinamide is frequently used for NMSC chemoprophylaxis. Recent studies raised concerns about cardiovascular risk associated with niacin metabolites,” they said.